Table 8C: Medicaid-Only HCBS Participants

Assessing the Health and Welfare of the HCBS Population

Table 8: Outcome Indicators for the Home and Community-Based Services Population by Participant Attributes, 2005^a

• Table 8A: National HCBS Population.
• Table 8B: Dually Eligible HCBS Participants.
• Table 8D: I/DD Subpopulation.
• Table 8E: SMI Subpopulation.
• Table 8F: HCBS Population Ages 18-64 Without I/DD or SMI.
• Table 8G: HCBS Population Age 65+.

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Outcome Indicator	White Only, Non-Hispanic	Black Only, Non-Hispanic	Hispanic	Other Race or Multiple Races, Non-Hispanic	Unknown Race	Male	Female	Ages 18-64	Ages 65-84	Age 85+	MSA	Non-MSA
Short-Term Complications of Diabetes	360	773	338	198	385	421	479	483	135	68	422	604
Min	s	s	s	s	s	s	s	s	s	s	s	s
Max	1,747	2,789	4,348	920	s	3,319	2,418	2,377	224	s	2,499	2,502
Asthma or Chronic Obstructive Pulmonary Disease	3,295	3,629	2,914	1,538	2,993	1,891	4,217	3,265	2,943	1,093	2,994	4,216
Min	s	s	s	s	s	s	741	350	s	s	644	s
Max	7,258	9,964	8,144	39,098	s	4,393	9,389	7,341	29,268	6,324	6,140	9,771
Congestive Heart Failure	2,032	4,937	3,036	1,846	2,466	2,248	3,378	2,734	4,613	5,307	2,914	2,884
Min	s	s	s	s	s	s	709	s	s	s	s	s
Max	4,983	12,523	17,391	20,571	s	4,702	11,441	8,678	15,107	60,606	8,690	10,572
Composite: Potentially Preventable Infection	4,813	5,440	5,071	3,905	4,328	4,713	5,066	4,830	5,546	7,676	4,718	5,711
Min	2,944	s	s	s	s	1,736	2,033	2,895	s	s	2,504	s
Max	9,544	19,861	13,163	15,038	s	11,618	10,194	11,161	39,024	30,303	11,642	10,899
Bacterial Pneumonia	3,187	3,167	3,096	2,615	2,839	3,059	3,158	3,064	3,465	5,034	2,960	3,728
Min	1,644	s	s	s	s	1,770	1,481	1,512	s	s	1,540	s
Max	5,668	9,238	9,506	15,038	s	7,469	6,055	6,354	19,512	15,152	6,329	7,065
Urinary Tract Infection	1,626	2,273	1,975	1,290	1,489	1,653	1,907	1,766	2,081	2,642	1,758	1,984
Min	s	s	s	s	s	405	527	800	s	s	784	s
Max	4,527	10,624	10,922	9,023	s	5,354	4,602	4,807	19,512	15,152	5,312	4,511
Infection Due to Device or Implant	785	1,026	736	571	625	697	907	850	500	s	797	915
Min	s	s	s	s	s	s	s	s	s	s	s	s
Max	3,478	4,157	3,661	3,352	s	2,490	3,154	2,607	1,720	s	3,052	2,462
Dehydration	1,076	1,600	1,037	695	998	1,017	1,297	1,180	1,047	1,594	1,102	1,503
Min	s	s	s	s	s	s	424	241	s	s	420	s
Max	2,984	3,172	15,190	10,526	s	2,595	3,564	2,834	4,364	6,186	2,567	3,717
Composite: ACSC Chronic Conditions	7,558	12,809	9,308	5,061	8,181	6,537	10,807	8,918	9,894	7,927	8,620	10,676
Min	s	s	s	s	s	1,309	1,778	840	s	s	604	s
Max	19,369	22,642	33,333	42,105	s	13,574	26,983	21,762	36,125	69,697	20,158	25,226
Composite: ACSC Acute Conditions	4,360	4,492	4,489	3,448	3,971	3,801	4,727	4,228	5,159	7,266	4,067	5,447
Min	2,039	s	s	s	s	1,685	2,033	2,290	s	s	2,066	s
Max	9,769	12,471	12,903	15,038	s	7,641	10,845	9,301	39,024	27,273	7,912	11,656
Composite: ACSC Overall	11,917	17,300	13,797	8,509	12,152	10,338	15,533	13,146	15,049	15,193	12,687	16,123
Min	3,503	s	s	s	s	2,333	5,185	3,498	s	s	3,109	s
Max	29,139	28,882	33,333	57,143	s	19,830	35,256	29,840	68,293	96,970	25,549	36,882
Pressure Ulcer	2,008	3,468	1,508	1,305	1,829	2,944	1,761	2,317	1,619	2,209	2,206	2,570
Min	s	s	s	s	s	509	377	567	s	s	785	s
Max	6,520	26,790	16,901	21,429	s	13,444	6,692	10,428	7,489	9,506	12,207	6,952
Injurious Falls	88	47	26	40	49	45	81	64	76	137	43	157
Min	s	s	s	s	s	s	s	s	s	s	s	s
Max	693	535	3,333	470	s	359	813	617	718	4,743	649	797

Notes: 

ACSC = ambulatory care-sensitive condition; I/DD = intellectual and development disabilities; MSA = metropolitan statistical area; SMI = serious mental illness.

^a. All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS population. HCBS population for outcome indicators excludes: individuals under age 18; people with only institutional use in a given quarter; people on managed care plans; and people in the States of Arizona, Maine, Washington, and Wisconsin.

Minimum (min) and maximum (max) defined as lowest rate and highest rate among States.

Dually eligible = dually eligible for Medicaid and Medicare. Eligibility for Medicare defined as inclusion in Medicare Denominator File.

Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.

HCBS subpopulations of I/DD, SMI, Under 65 Without I/DD or SMI, and 65+ are defined as in the Appendix.

s = Suppressed due to small cell size.

Source: Agency for Healthcare Research and Quality (AHRQ), Medicaid Analytic eXtract (MAX) data, and Medicare Provider Analysis and Review (MedPAR) data.

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